A High, A Low, and a laugh

Por fin! (finally) I was able to get some more pix uploaded. Mostly for the benefit of the Grandparents, Aunts, Uncles and Cousins. You know how it is. ;-)

The kids playing at one of the parks in our town, Estelí

Jordan, alive and well! (see below regarding the need for proof)

Here, the girls are hanging out while Michael and I wait in line to renew all our visas at the Costa Rican border. The girls are growing quite accustomed to all the waiting around as we travel around the country. There is a bus and taxi driver strike going on here over fuel prices (thats a very truncated version), so getting back home became a challenge. We made it though, unharmed.

Devyn in her school uniform

This is Elayne, our neighbor and the girls best play mate. They have made a fort. In other words, life as usual around here.

These pix are of that great day at the Optica. They don't quite capture the mood, but at least you can get the idea. (see below)






“High—Low”

Sometimes around the family dinner table, we ask one another about the high and low points of each person’s day. We’ve had a number of interesting conversations inspired by these reflections. As I think about the events of March and April, I realize that within these two months I have experienced my highest and lowest moments since we have been living here in Nicaragua, and I thought I’d share them in this blog. (At dinner, we often start with our “low” moments, and then we end on a “high” note. So that’s how I’ll proceed here...)

My “Low”

In late March, Jordan got sick—really sick—and we learned in a very tangible way how much we appreciate the quality of health care in the United States (despite its often dysfunctional character and inequitable distribution).

Shortly after Michael began improving from his bout with hepatitis A, Jordan came down with a high fever, a very painful throat, and a major headache—all of which seemed to persist. We just figured she had picked up the flu-like virus that had been moving among the locals, and we hunkered down to wait it out. After about a week, Jordan improved for about two days, and we thought she was in the clear. All of a sudden, however, she spiked another high fever, this time accompanied by swollen glands (with lots of pain in her ears, throat and head), vomiting, diarrhea, and lethargy. No longer sure this was just some flu virus, we decided not to wait any longer and we sought medical advice.

After an initial blood test, the doctor (the same one Michael has been seeing for the hepatitis) prescribed an antibiotic for an apparent bacterial infection in her throat, along with some pain relief and anti-inflammatory medications. Another week went by. Jordan was still not improving AND she was losing quite a bit of weight. At the end of the third week, the fever finally left and she was feeling a little more energetic. Once again, we thought we were in the clear, though Jordan’s throat still hurt. Then, all of a sudden the sides of her throat swelled and became very hard to the touch. It was like Jordan had swallowed two golf balls and one was stuck on each side of her neck. We returned to the doctor (with whom we had been in regular conversation the whole time).

It was about 4:30pm when we saw the doctor. After a very brief look at Jordan, she quickly referred us to a pediatrician friend who, after examining Jordan, said she needed to have an ultrasound, and then she would need to be hospitalized—immediately. WHAT?!?!?! As you might imagine, we were asking the pediatrician question after question: Why? Where? What type of treatment? She said that Jordan’s case was very “troubling,” and mentioned meningitis and lymphoma as things they needed to rule out. And, in the city of Estelí, the degree of treatment she needed to receive was ONLY offered in the hospital. Picture me having more than just a little (albeit, internal) cow at this point, and planning ways (in my head) to get another opinion.

We raced across town to the laboratory for the ultrasound. The doctor there knew us well by now after having run tests on Michael numerous times. Although the lab was about to close for the evening when we arrived, the doctor immediately got Jordan on the table for an ultrasound. Since we hadn’t expected any of this to happen when we initially left the house, we hadn’t taken enough money to cover all of these doctors and tests. We were now completely out of cash, and we were supposed to take the ultrasound results back to the pediatrician’s house for a final consultation so that she could write up a referral for the hospital.

When the ultrasound results were ready, the doctor kindly let us leave with nothing more than a promise that we’d return to pay as soon as we could. We got a cab to the pediatrician’s house, and then returned home to gather some things for what was to be a minimum of three nights (and perhaps as much as ten, we were told) in the hospital. In sum, we saw three doctors within two hours and each one took turns freaking out—or, more likely, we were freaking out when we saw their concerned looks—when they noted the size and hardness of Jordan’s swollen neck. Needless to say, our stress levels were off the graph—exacerbated by the fact that we were not entirely confident in the medical information we were getting. Not to mention that this was all in Spanish, and medical vocabulary is not something we necessarily use every day. I was far from being comfortable with the idea that Jordan was to be given even more antibiotics. But I had only my maternal instincts to back up my skepticism, and so we proceeded on to the hospital.

To say that a public hospital in a small city in a developing country leaves a little to be desired would be an enormous understatement. The emergency room itself was a safety hazard. As we entered, Jordan asked in a fear-stricken, yet brave voice, “Is this the best place we can go?” Many people, young and old, were suffering from a variety of medical conditions. Bloody gauze, cotton swabs, and used needles were sitting in open garbage cans. The patients were separated from one another—if at all—by a curtain, which, in most cases, was not drawn closed. The smell of old urine was strong enough to make your eyes water. There were babies screaming, and adults hacking. It was like something out of war movie. When the nurse began to administer Jordan’s IV (for a dual antibiotic therapy), she told Jordan to climb up onto the examination bed. Covering the bed was an old, bloodstained sheet. When I objected to having Jordan on it, the nurse simply folded the nearest bloodstain under and again instructed her to climb up onto the table. (There was still a bloodstain right near where Jordan’s head ended up.) Although Jordan was trying her best to be brave, she was now very afraid and in tears.

I told myself that if the pediatric ward wasn’t much better than the emergency/admitting room, we were not staying. What Plan B would be at that time of night, I still hadn’t worked out in my mind. When we got to the pediatric ward, it was a smidgen better—at least the smell of urine wasn’t as strong. Still, we were escorted to a plastic-covered twin bed with nothing but a holey top sheet in a stuffy room with 10 other sick children and their mothers—with one bathroom. Not much better. This was where Jordan and I were to spend the night.

Of the three doctors we encountered prior to making our way to the hospital, none of them thought to mention to us gringos that the FREE public hospital’s (our only option) accommodations would NOT include pillows, toilet paper, soap, water, bedding, fresh air, mosquito nets, darkness (the fluorescent lights remained on all night), cleanliness, bedside manners or quiet. Not even Band-Aids. All the locals knew this, and thus they came prepared with their own necessities. We, on the other hand—well, let’s just say we arrived ill prepared.

Michael left to sleep at the house with Devyn and Jordan and I stayed in the hospital—a very long, hot, worrisome night. At about 3:00am, I was still awake. (Jordan and I were sharing the twin mattress, just as all the other mothers and children were doing). I was getting eaten alive by mosquitoes, the lights were STILL on, the nurses were laughing and talking in the hall right outside the door, and I was worrying myself into a tizzy over Jordan. I looked around the room at all the other mothers and their children who were sleeping, seemingly calm and unfettered by this situation. (It has been my observation that many Nicaraguans can sleep anywhere and in just about any circumstance).

And then it hit me! Perhaps due to a jolt of clarity or sleep-deprived insanity, it became crystal clear that we needed to get out of there. Prior to this epiphany, I had been telling myself we could handle this. If the Nicaraguans had to endure these conditions, so could we. But the more I assessed the circumstances and saw that every child was apparently receiving the same antibiotic treatment (for what, we still didn’t know), that the dozen or so hygiene infractions occurring in a room of 15 people could put us both at even more risk health-wise than we were already, and that rest was not going to be an option, I decided that the treatment Jordan was getting was in no way therapeutic, and could, in fact, be harmful. So, feeling sorry for all the other mothers who were without the financial resources to do the same thing, I called Michael at 4:30 in the morning and in what we now fondly refer to as my “mommy bear melt down” explained that we were definitely leaving for Managua (the capital city that has private hospitals) as soon as the doctor could call in the discharge papers. I did not care how much a private hospital in Managua might cost.

My next step was to figure out which hospital to go to once we arrived in Managua, so I called our friends, Doug and Penn, who live there. It only took Penn five seconds to recognize a panicked mother’s voice (the fact that it was 6:30am was also probably a clue) and to ask me what was wrong. Without hesitation, she and Doug offered to come pick us up and take us to the best hospital in town.

Allow me to sidetrack a bit here and sing the praises of these two gems of people, who came to our rescue. Doug and Penn are two classic examples of human goodness. Not only did they make a four-hour round trip to take us to the hospital in Managua, they also stayed with us during Jordan’s exams and opened their home to us to spend the night, offering dinner, emotional support, and even entertainment. In this time of crisis, Doug and Penn went way beyond the call of duty. Doug and Penn, you are the salt and light of the earth, and we cannot thank you enough for the kindness and generosity you offered our whole family. Know that in your honor we will make every effort to pass on the goodness you have shown us to others we encounter in need. In other words, you may never need for us to pay you back your generosity, but we will indeed, pay it forward.

Ok, back to my story. We arrived at the (private) hospital in Managua. The stark contrast between this hospital and the public general hospital in Estelí was simply staggering. It is shiny and clean, it smells nice, there are special receptacles for hazardous materials, people are ready and willing to assist you (and to repeat themselves one more time when you’re just not sure you caught that last word), and there are even BAND AIDS!

After a call made on our behalf by Jordan’s school principal (thank you, again, Cristina!), we were seen immediately by a very pleasant female doctor, a specialist in pediatric infectious diseases. The doctor gave Jordan a thorough exam, ordered a few tests, and determined that (1) Jordan did not need to be hospitalized; (2) she did not need antibiotics (note to self—those maternal instincts are often guiding you correctly and should not be dismissed); and (3) she most likely had mononucleosis (“mono”).

Whew! I did not realized how long I hadn’t been breathing until I started again. Oh that wonderful feeling of respiration: In—out, in—out. Repeat. ;-)

After some blood tests, an ultrasound, and a chest x-ray, we were informed that Jordan’s ailment was indeed mono—and not something horribly worse. Given the other possibilities we had feared, mono was not really a big deal. It would only require continued rest as the virus took its course (which the doctor said would last about another week given the fact that Jordan had been sick for three weeks already). We were given an appointment for a check-up ten days later and sent on our way.

The End.

Believe it or not I actually left out a bunch of details. In any event, Jordan is fine now. And I would like to add that in the midst of this whole crisis we were amazed at the overwhelming concern and support we received from the community here in Estelí. Being newcomers, we had to rely on the recommendations of the people we knew to guide us toward doctors, pediatricians, and so forth. Of course this required explaining why we needed the information in the first place and word spread around that we were in a bit of a crisis. As a result, we had at least a dozen people calling us to find out how Jordan was doing, if there was anything they could do to help, and that we could call anytime, for any reason. We were overwhelmed with well wishers offering to help, and it hit home that in just a short time here we have developed a community—a community we are really going to miss.

My “High”

I have already told you about my volunteer work with the women’s project, Mujeres Ambientalistas. I also mentioned earlier that many of them needed glasses. Right from the beginning, it became really evident to me that not seeing would be a huge obstacle to these women’s ability to manage better their paper making business. Few people wear glasses here, not because they don’t need them, but because glasses are way beyond the financial reach of the average person. I had been telling my mom all about the things I was learning about and doing with the women’s project. She was very supportive and right away wanted to donate some money for whatever I thought the women might need to use it for. When the need for glasses presented itself, I knew immediately that buying these women glasses was exactly how we should use my mom’s donation. And by this time, my stepfather and grandmother had also added their own donations to the pot.

So, we picked a day, and three women from the project and I went to the Optica (optometrist) for eye exams and eyewear. This was, for me, the most exhilarating experience. These are women who probably only have two pairs of shoes—flip-flops, and a nicer pair for church. These are not women who shop. They are not the type to go out for the day and try on dresses, window shop for shoes, or spend the day at the mall. Their shopping habits involve getting food, some cleaning items, and maybe an occasional pen and notebook. But on this day, they were like schoolgirls going shopping for jewelry—trying on a pair of frames and then turning for the others to see with a head cock and a hand on the hip, as if to say, don’t THESE make me look glamorous. Each, in turn, would give a nod of approval, a compliment, a laugh—or, a wrinkle of the nose, indicating that maybe a different pair would look better. And I got to watch and be a part of it all! They were giddy with the notion of being able to see their world more clearly, and I was giddy with them. They all finally decided on glasses they liked best—taking their sweet time as they made their choices, in true Nica style. I think we were at the store for a few hours at least. The prescriptions were written and sent off for the orders to be filled, and we all left with big smiles on our faces.

I don’t know who was more thrilled, the women who were receiving the glasses, or me, the one serving as the conduit for their reception. The euphoric feeling that I went home with that day makes me think I got the bigger emotional high. I thought to myself, if one could only bottle this feeling and market it widely enough so that everyone could experience it personally, much of the poverty and suffering in the world could be eradicated given the miraculous generosity that would ensue. I did nothing but connect a generous givers with a few people who could greatly benefit from the gift. Nevertheless, I felt as good as (if not better than) I did when I crossed the finish line of a half marathon, or when I got an A on a test for which I had studied hard. It felt pure, natural—right.

I couldn’t wait to tell my mom and step dad about the whole experience, so that they, too, could share in the emotional high. As you might imagine, they were pleased, and my mom has since started her own little fundraising campaign to collect more funds for whatever other expenses these women may need in order to grow their business. I love being able to thwart would-be obstacles. I also really like just being the conduit and not the purse. The women know that it is my “people” who are giving to them, not me personally, and it allows us all to sidestep a lot of awkwardness. To be honest, simply having the chance to work with these women in the first place is the biggest high of all, and knowing that they can see better now only makes the entire experience sweeter.

Again, and again, I am struck that everyday resources most of us in the United States take for granted—for instance, things as common as a pair of glasses, or adequate health care—are way out of reach for the poor. Poverty, it would seem, involves mountains of small, almost invisible obstacles that hinder real, hardworking people from doing the kinds of things those of us with money take completely for granted. Come to think of it, I suppose that while most of us in the United States can probably find a pair of glasses if we need them, it’s worth noting that somewhere in the neighborhood of 47 million Americans lack health insurance. Hmm . . .



On a less serious note: “The Case of the Mystery Poo”

The mystery poo . . .

Who and what left the mystery poo?
It’s too little to be from a cat,
too big to be from a rat,
but definitely poo.

It was in the girls’ room, near the door.
It wasn’t there the evening before.

At first glance,
we thought it was a slug—in Spanish, “gusano,”
but upon closer inspection—
clearly something’s guano.

But who, rather WHAT,
came ‘round while we were asleep,
and left these remains
that we now peep.

It’s giving me the creeps,
this mysterious “shi-eet.” ;-)

Ok! ok! So maybe all this heat is getting to me, OR I’ve been reading too much Dr. Suess to Devyn. (Let’s hear it for those crazy Sneetches who finally learned that it doesn’t matter whether they do or don’t have “stars upon thars!”)

Thanks for tuning in. CHAO!!
-Kelli